VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-00832
Package ID: USCOURTS-cofc-1_18-vv-00832
Petitioner: Kimberly A. Purtill
Filed: 2018-06-12
Decided: 2021-02-01
Vaccine: influenza
Vaccination date: 2015-09-30
Condition: left shoulder injuries related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 50000

AI-assisted case summary:
Kimberly A. Purtill filed a petition for compensation on June 12, 2018, alleging that she suffered left shoulder injuries related to vaccine administration (SIRVA) as a result of an influenza vaccine received on September 30, 2015. The respondent initially moved to dismiss, arguing that Ms. Purtill failed to provide evidence of the six-month severity requirement. However, the Chief Special Master denied this motion, finding that the evidence showed her injury persisted for more than six months. The respondent did not raise any other challenges to entitlement. On May 7, 2020, the Chief Special Master issued a Ruling on Entitlement, finding Ms. Purtill entitled to compensation for a Table SIRVA. The decision detailed how Ms. Purtill met all the criteria for SIRVA, including lack of prior condition, onset of pain within 48 hours of vaccination, pain limited to the affected shoulder, and no other condition explaining the symptoms. On December 4, 2020, the respondent filed a proffer agreeing to an award of $50,000.00, which Ms. Purtill accepted. On February 1, 2021, the court issued a Decision Awarding Damages, granting Ms. Purtill a lump sum payment of $50,000.00.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-00832-0
Date issued/filed: 2019-12-27
Pages: 8
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/12/2019) regarding 31 Findings of Fact & Conclusions of Law, Signed by Chief Special Master Brian H. Corcoran. (ypb) Service on parties made.
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Case 1:18-vv-00832-UNJ Document 34 Filed 12/27/19 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-0832V
UNPUBLISHED
Chief Special Master Corcoran
KIMBERLY A. PURTILL,
Dated: November 12, 2019
Petitioner,
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Motion to Dismiss; Six Month
HUMAN SERVICES, Residual Effects or Sequelae;
Influenza (Flu) Vaccine; Shoulder
Respondent. Injury Related to Vaccine
Administration (SIRVA)
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Robert Paul Coleman, III, U.S. Department of Justice, Washington, DC, for Respondent.
ORDER DENYING MOTION TO DISMISS AND FINDING OF FACT ON
SIX MONTH REQUIREMENT 1
On June 12, 2018, Kimberly Purtill filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10, et seq.,2 (the
“Vaccine Act”). An amended petition was filed on July 31, 2018 (ECF No. 9). In it,
Petitioner alleges that she suffered a left shoulder injury related to vaccine administration
(“SIRVA”) as a result of a September 30, 2015 influenza (“flu”) vaccine. Petition at 1. The
case was assigned to the Special Processing Unit (“SPU”) of the Office of Special
Masters.
1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am
required to post it on the United States Court of Federal Claims' website in accordance with the E-
Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of
Electronic Government Services). This means the decision will be available to anyone with access to
the internet. In accordance with Vaccine Rule 18(b), petitioner has 14 days to identify and move to
redact medical or other information, the disclosure of which would constitute an unwarranted invasion of
privacy. If, upon review, I agree that the identified material fits within this definition, I will redact such
material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for
ease of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C.
§ 300aa (2012).

Case 1:18-vv-00832-UNJ Document 34 Filed 12/27/19 Page 2 of 8
Respondent has now filed a motion to dismiss the petition, alleging that Petitioner
has failed to provide evidence to satisfy the six-month severity requirement set forth in
Section 11(c)(1)(D)(i) of the Vaccine Act (ECF No. 25). For the reasons discussed below,
Respondent’s motion is denied.
I. Factual Background
On September 30, 2015, Ms. Purtill, then a 53-year old virtual critical care
supervisor and registered nurse, received a flu vaccine intramuscularly into her left arm.
Petitioner’s Exhibit (“Pet. Ex.”) 1 at 1; 3 at 8. In her affidavit, Petitioner avers that she felt
pain in her left shoulder “[i]mmediately after vaccination.” Pet. Ex. 5 at 1 ¶ 3. She averred
that she expected the pain would go away but that instead it got worse. Id.
On October 21, 2015, Petitioner reported to an urgent care center operated by her
employer, Carolinas Health System. Pet. Ex. 3 at 1. Her chief complaint was that she
had gotten a flu shot on September 30 and that her left shoulder joint was still “hurting a
lot.” Id. She reported that she received her flu shot with a 20-gauge one inch needle in
her left deltoid three weeks earlier. Id. The evening of the flu shot, she noticed mild
aching pain in her left shoulder, and the pain had progressed since then. Id. She reported
that the pain was worse with abduction and forward flexion of the left shoulder and was
somewhat improved with Aleve. Id. She denied a history of left shoulder pain. Id. She
was given prednisone. Id. at 2.
A Work Status/Treatment Report, also dated October 21, 2015, indicated that
Petitioner’s injury occurred on September 30, 2015. Pet. Ex. 2 at 1; 3 at 7. A Radiology
Interpretation Requisition from the same date indicates that Petitioner had normal left
shoulder studies. Pet. Ex. 3 at 5. The clinical indication for the studies was flu vaccine
in Petitioner’s left arm four weeks earlier and complaints of pain for four weeks. Id.
On November 16, 2015, Petitioner reported to Carolinas Healthcare System’s
Employee Health Division and was examined by Dr. Larry Raymond. Pet. Ex. 3 at 8. She
reported persisting and worsening left shoulder pain for six weeks due to a flu shot on
September 30, 2015. Id. She reported that both abduction and adduction were quite
painful. Id. She reported waking at night when she rolled over. Id. She reported that a
steroid taper had eliminated the radiating pain that was reaching her left elbow but that
local deltoid pain and tenderness remained. Id. Petitioner reported no prior left shoulder
discomfort or similar reaction to a flu shot. Id.
On examination, Dr. Raymond found that Petitioner exhibited evidence of left
rotator cuff tendinitis, left deltoid myositis, and focal tenderness to palpation. Pet. Ex. 3
at 8. Dr. Raymond noted positive Neer’s and empty can impingement signs, as well as
other signs of rotator cuff tendinitis. Id. Dr. Raymond assessed Petitioner with an
“[a]dverse effect of influenza immunization with L deltoid myositis and brachial neuritis
also involving rotator cuff (supraspinatus & infraspinatus).” Id.
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Case 1:18-vv-00832-UNJ Document 34 Filed 12/27/19 Page 3 of 8
Dr. Raymond prescribed a non-steroidal anti-inflammatory drug (“NSAID”) and
topical diclofenac gel. Pet. Ex. 3 at 8. He noted that Petitioner may need to be seen
again in 1-2 weeks. Id.
On March 23, 2016, Petitioner reported to Dr. Raymond for a follow up
examination. Pet. Ex. 3 at 9. The record noted that she had left shoulder pain after a flu
shot in the fall and got “quite a lot of relief” from a prednisone taper. Pain donning her
shirt or rolling over in her sleep “got up to 8/10.” Id. The pain locations were recorded as
“L retroclavicular, L forearm radiating up to shoulder, some L supraspinatus.” Id. The
note continues, “No (sic) pain is gone except occ. 2 of 10 in” left supraspinatus area
donning shirt. Id. I interpret the “no” in this sentence as meaning “now.” With this
interpretation, the record indicates that as of March 23, 2016, Petitioner’s pain was gone,
except for occasional relatively minor pain while putting on a shirt.
On examination, Dr. Raymond noted “[n]o discomfort induced by ‘JAMA 2014’
maneuvers (painful arc and pressing dorsum of hands into thoracic spine). Pet. Ex. 3 at
9. Dr. Raymond summarized that, “[a]fter 4 months of pain, the steroid taper 40/day x 3
down to 5 mg/d over 10 days erased most of her pain.” Id. (emphasis added). He
indicated a reluctance to prescribe more prednisone and noted that Petitioner did not
want that either. Id. Dr. Raymond’s treatment plan noted that “shoulder rolls and other
ROM exercises may help prolong her remission. If pain recurs, will refer her for PT.” Pet.
Ex. 3 at 9. He noted that he did not think that an orthopedic referral would help at this
time. Id. At the bottom of the page, underneath Dr. Raymond’s signature, there is a note
stating, “Next seen @ Med OV for unrelated matter, 5/27/16, No mention of shoulder.”
Id.
In her supplemental affidavit, Petitioner averred that on March 23, 2016, she
reported to Dr. Raymond “that following two courses of prednisone my left shoulder pain
had mostly resolved, however, my range of motion was limited, my left arm strength was
limited and I experienced increased pain with the use of my arm. I continued to take Aleve
twice daily to control my symptoms, in addition to heat or ice and use of an over the
counter TENS unit (transcutaneous electrical nerve stimulation).” Pet. Ex. 7 at ¶ 7.
Petitioner reported that Dr. Raymond instructed her to perform home exercises and return
if her pain increased. Id. at ¶ 8. Petitioner averred that she “did not return to Dr. Raymond
as my pain leveled off, and I did not believe that anything further could be done to treat
my left shoulder pain.” Id. at ¶ 9.
On May 27, 2016, Petitioner was seen by physician assistant Timothy Kelley. Pet.
Ex. 4 at 129. She reported that she would like to discontinue an anxiety/depression
medication secondary to possible gastrointestinal issues. Id. There is no indication at
this time that she reported shoulder pain, and no musculoskeletal examination was
recorded. Id. at 129-146.
On September 2, 2016, Petitioner was seen by physician assistant Timothy Kelley
for anxiety. Pet. Ex. 4 at 61. There is again no indication that she reported shoulder pain,
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Case 1:18-vv-00832-UNJ Document 34 Filed 12/27/19 Page 4 of 8
and no musculoskeletal examination was recorded. Id. at 61-78. The page following this
record is an undated request for medical exemption from the influenza vaccination for
2016-2017 indicating that Petitioner had “a contraindication that warrant[ed] a medical
exemption from the influenza vaccine.” Pet. Ex. 4 at 65. The form is signed by physician
assistant Kelley. Id.
On October 31, 2016, Petitioner reported to Dr. Grant Campbell for an annual well
women examination. Pet. Ex. 6 at 7. There is no indication that she reported shoulder
pain. Id. at 7-23. In the musculoskeletal section of the review of systems, the record
states “Negative.” Pet. Ex. 6 at 7. In the physical examination section, the record states,
“Normal range of motion, No deformity.” Id.
On November 29, 2016, Petitioner reported to Dr. Timothy Hodges complaining of
bilateral scapular pain, bilateral flank pain, and intractable headache. Pet. Ex. 4 at 80.
Petitioner reported bilateral scapular pain and flank pain since November 1, 2016. Id.
The scapular tenderness was not made worse by flexion, extension, or lateral rotation,
and was worst when she was recumbent lying in bed. Id. On examination, she was found
to have “[b]ilateral trapezius spasm with palpable tenderness.” Id. at 82. She was
diagnosed with chronic scapular pain and instructed to follow up in one to two weeks. Id.
Chest radiology studies were done and found to be normal on November 29, 2016.
Pet. Ex. 4 at 95. The testing was done due to “upper back pain for about 1 month.” Id.
Petitioner was excused from work for the day. Id. at 113.
In her supplemental affidavit, Petitioner stated, “I did discuss my ongoing left
shoulder pain with my primary care physician at routine visits.” Pet. Ex. 7 at ¶ 9. She
does not provide dates of these discussions and does not indicate the nature and
resolution of the discussions. The only primary care record that refers to shoulder pain
is the November 29, 2016 visit with Dr. Hodges for bilateral scapular pain, Pet. Ex. 4 at
80.
II. Relevant Procedural History
Petitioner filed with her petition medical records and an affidavit as Pet. Exs. 1-5
(ECF No. 1) and filed a Statement of Completion on June 14, 2018 (ECF No. 5).
Following the initial status conference on July 23, 2018, Petitioner was directed to file
additional medical records (ECF No. 8). On July 31, 2018, Petitioner filed an amended
petition, additional medical records, and a Statement of Completion (ECF Nos. 9-11).
On April 8, 2019, Respondent filed a status report stating that he had requested
from Petitioner that she file proof that she satisfied the six-month severity requirement to
demonstrate entitlement to compensation (ECF No. 19). On April 23, 2019, Petitioner
was directed to file evidence demonstrating that she suffered the effects of her injury for
at least six months and an amended Statement of Completion (ECF No. 20). On the
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Case 1:18-vv-00832-UNJ Document 34 Filed 12/27/19 Page 5 of 8
same day, April 23, 2019, Petitioner filed an amended Statement of Completion (ECF No.
21). Petitioner stated:
On March 23, 2016, five (5) months and twenty-three (23) days following
receipt of the influenza vaccine, Petitioner returned to Dr. Raymond with
ongoing left shoulder pain. At that time, she reported, “Pain donning shirt
or rolling over in sleep got up to an 8/10.” At that time Dr. Raymond
recommended home-exercises.
There are no additional medical records.
Petitioner’s Amended Statement of Completion, filed April 23, 2019 (ECF No. 21).
On July 31, 2019, Respondent filed a Rule 4(c) report and motion to dismiss (ECF
Nos. 24, 25). Respondent argued that Petitioner was not entitled to compensation
because she had not satisfied the six month severity requirement. Rule 4(c) report at 4.
Respondent stated that although Petitioner attended medical appointments outside of the
six-month timeframe, “at none of those visits did she mention any left shoulder
complaints. See Ex. 4 at 80-86, 95-96, 109, 115-119, 129-131.” Id. at 4-5. Respondent
further noted that at Petitioner’s March 23, 2016 visit, Dr. Raymond “indicated that
petitioner’s condition was much improved and that she did not require any additional
medication.” Id. at 5 (citing Pet. Ex. 3 at 9). Thus, Respondent asserted that there was
an “absence of any objective contemporaneous evidence that petitioner suffered from left
shoulder pain more than six months after the September 30. 2015 vaccine was
administered” and thus had failed to demonstrate entitlement to compensation. Id. at 5.
Thus, Respondent argued that the petition should be dismissed. Id.
On August 16, 2019, Petitioner filed a supplemental affidavit, Pet. Ex. 7, and a
response opposing the motion to dismiss (ECF Nos. 27, 28). Petitioner argued that
respondent’s motion to dismiss should be denied because “the evidence submitted
demonstrates by preponderant evidence that her left shoulder injuries continued through
March 30, 2016.” Petitioner’s Response at 1. Petitioner asserted that pursuant to Court
of Federal Claims Rule 56(a) and Vaccine Rule 8(d), the court should enter judgment in
favor of a moving party if there is no genuine dispute as to any material fact and the
moving party is entitled to judgment as a matter of law. Id. at 3. Petitioner argued,
“[d]ismissal is not appropriate if it appears the parties reasonably contest the length of
time that petitioner has suffered from the effects of his alleged vaccine injury.” Id. at 4.
Petitioner asserted that her medical records and affidavits established that it was
more likely than not that she suffered the residual effects of her left shoulder injury for at
least six months after her flu shot. Petitioner’s Response at 4. Petitioner argued that
residual effects are “symptoms manifested due to the vaccine related injury” and that
5

Case 1:18-vv-00832-UNJ Document 34 Filed 12/27/19 Page 6 of 8
“[d]ischarge from medical care does not necessarily indicate there are no residual
effects.” Id.
Petitioner argued that her medical records reflected that on March 23, 2016, five
months and 24 days following her vaccination, she reported that a steroid taper “erased .
. . most of her [left shoulder] pain.” Petitioner’s Response at 5 (emphasis in original).
Petitioner argued that in this context, the use of the term “most” implied that not all of her
left shoulder pain had resolved. Id. Petitioner asserted that her affidavit corroborates
this, indicating that while a second taper of steroids improved her symptoms, she still had
limited range of motion and weakness in her left shoulder. Id. Petitioner acknowledged
that her medical records did not corroborate all of her symptoms, but Dr. Raymond’s
records noted some residual symptoms of her left shoulder pain. Id. Petitioner argued
that her affidavit, as supported by her medical records, demonstrated by preponderant
evidence that she suffered the residual effects of her injury for at least six months. Id.
III. Relevant Legal Standards
Under the Vaccine Act, a petition for compensation must contain “supporting
documentation, demonstrating that the person who suffered [a vaccine related injury] ...
suffered the residual effects or complications of such illness, disability, injury, or condition
for more than 6 months after the administration of the vaccine.” Vaccine Act
§ 11(c)(1)(D)(i). The burden of establishing, by a preponderance of the evidence, the
persistence of a vaccine-caused injury for longer than six months is borne by Petitioner.
Vaccine Act § 13(a)(1)(A); Song v. Sec'y of Health & Human Servs., 31 Fed. Cl. 61, 65–
66 (1994), aff'd, 41 F.3d 1520 (Fed. Cir. 1994). A Petitioner cannot establish the length
or ongoing nature of an injury merely through self-assertion unsubstantiated by medical
records or medical opinion. Vaccine Act § 13(a)(1)(A).
A special master must consider, but is not bound by, any diagnosis, conclusion,
judgment, test result, report, or summary concerning the nature, causation, and
aggravation of Petitioner’s injury or illness that is contained in a medical record. Vaccine
Act § 13(b)(1). “Medical records, in general, warrant consideration as trustworthy
evidence. The records contain information supplied to or by health professionals to
facilitate diagnosis and treatment of medical conditions. With proper treatment hanging
in the balance, accuracy has an extra premium. These records are also generally
contemporaneous to the medical events.” Curcuras v. Sec’y of Health & Human Servs.,
993 F.2d 1525, 1528 (Fed. Cir. 1993).
IV. Analysis
The purpose of the Vaccine Act is to award “vaccine-injured persons quickly,
easily, and with certainty and generosity.” Weddel v. Sec’y of Health & Human Servs.,
100 F. 3d 929, 932 (Fed. Cir. 1996) (quoting H.R. Rep. No. 99-908, at 3 (1986)). The Act
was meant to remedy the problem that “for the relatively few who are injured by vaccines
– through no fault of their own – the opportunities for redress and restitution [were] limited,
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Case 1:18-vv-00832-UNJ Document 34 Filed 12/27/19 Page 7 of 8
time consuming, expensive, and often unanswered.” Cloer v. Sec’y of Health & Human
Servs., 654 F.3d 1322, 1325 (Fed. Cir. 2011) (en banc) (quoting H.R. Rep. No. 99-908,
at 6 (1986)). As a result, the program places some emphasis on speed and efficiency,
especially in close cases.
The Vaccine Act requires that a Petitioner demonstrate that “residual effects or
complications” of a vaccine related injury continued for more than six months. Vaccine
Act § 11(c)(1)(D)(i). “[T]he fact that a Petitioner has been discharged from medical care
does not necessarily indicate that there are no remaining or residual effects from her
alleged injury.” Morine v. Sec’y of Health & Human Servs., No. 17-1013, 2019 WL
978825, at *4 (Fed. Cl. Spec. Mstr. Jan. 23, 2019); see also Herren v. Sec’y of Health &
Human Servs., No. 13-1000V, 2014 WL 3889070, at *3 (Fed. Cl. Spec. Mstr. July 18,
2014) (“a discharge from medical care does not necessarily indicate there are no residual
effects”). In another SPU case, where a Petitioner’s last treatment was at five months
and nine days, the Petitioner was found to meet the six month requirement. Schafer v.
Sec’y of Health & Human Servs., No. 16-0593V, 2019 WL 5849524 (Fed. Cl. Spec. Mstr.
Aug. 28, 2019). In that case, the special master noted that it was unlikely “that petitioner’s
shoulder symptoms would have resolved within 22 days.” Id. at *7.
In this case, it is undisputed that Petitioner received a flu vaccination on September
30, 2015 in her left deltoid. The parties have not raised any dispute concerning the onset
of Petitioner’s left shoulder pain and there is preponderant evidence that the onset of her
pain was immediate. The parties have not disputed that Petitioner was seen by Dr.
Raymond on March 23, 2016, seven days short of the six-month period. In order for
Petitioner to establish more than six months of residual effects, she must demonstrate
that her residual symptoms continued until at least one week after her March 23, 2016
appointment with Dr. Raymond.
Respondent emphasizes that at the March 23, 2016 appointment Petitioner’s
condition was greatly improved and that medication was no longer needed. Rule 4(c)
report at 5. Petitioner, however, focuses on Dr. Raymond’s note indicating that most, and
thus by implication, not all, of Petitioner’s pain was erased by the steroid taper.
The most persuasive evidence concerning Petitioner’s condition on March 23,
2016 is Dr. Raymond’s note that Petitioner’s “pain [was] gone except occ. 2 of 10 . . .
donning shirt.” Pet. Ex. 3 at 9 (emphasis added). This implication of this is that
Petitioner’s pain was not completely gone, since she was still experiencing occasional
pain getting dressed as of March 23, 2016. This is supported by the note cited by
Petitioner indicating that most of her pain was erased by the steroid taper. Pet. Ex. 3 at
9. This is further supported by Petitioner’s statement in her supplemental affidavit that
she reported on March 23, 2016, that her left shoulder pain had mostly resolved and that
she experienced increased pain with the use of her arm. Pet. Ex. 7 at ¶ 7.
Moreover, eight months later, on November 29, 2016, she was seen by her primary
care physician for bilateral scapular pain. Pet. Ex. 4 at 80. Petitioner’s November 29,
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Case 1:18-vv-00832-UNJ Document 34 Filed 12/27/19 Page 8 of 8
2016 appointment for shoulder pain further suggests that she continued to suffer lingering
effects of her injury in the interim period.
Petitioner has further explained why she did not return to Dr. Raymond after the
March 23, 2016 visit – her pain had leveled off (even if some remained) and she did not
think any further treatment was available. Id. at ¶ 9. This is consistent with Dr. Raymond’s
reluctance to prescribe further treatment on March 23, 2016, when he indicated he did
not want to prescribe more prednisone, did not think an orthopedic referral would help,
and suggested that she continue home exercises. Pet. Ex. 3 at 9.
Taken as a whole, this evidence supports a finding that as of March 23, 2016,
Petitioner was still experiencing occasional and minimal residual symptoms, including left
shoulder pain while getting dressed. Her treating physician considered further treatment
options but determined that further treatment was not warranted at that time.
Thus, I find it more likely than not that a shoulder injury that was still causing
occasional pain after five months and twenty-three days (which is 175 days) would not
fully resolve within the following week. Therefore, I find it more likely than not that
Petitioner suffered the residual effects of her left shoulder injury for more than six months
(if barely). I do not make this finding based solely on Petitioner’s assertions, but also on
corroborating medical records, specifically the record of her March 23, 2016 visit with Dr.
Raymond, Pet. Ex. 3 at 9, and the record of her November 29, 2016 appointment, Pet.
Ex. 4 at 80. Taken as a whole, the record establishes that she suffered the residual
effects of her injury for more than six months.
This is a close case. The evidence supporting residual effects for more than six
months barely tips in Petitioner’s favor. However, “[i]n the Vaccine Program, petitioners
are accorded the benefit of close calls.” Roberts v. Sec’y of Health & Human Servs., No.
09-427V, 2013 WL 5314698, at *10 (Fed. Cl. Spec. Mstr. Aug. 29, 2013).
V. Conclusion
For the reasons stated above, I DENY respondent’s motion. I find, based on
the record as a whole, that Petitioner has established that she suffered the residual
effects of her vaccine-related injury for at least six months.
Respondent shall file, by no later than Thursday, December 12, 2019, a status
report indicating how he intends to proceed in this case in light of this decision.
IT IS SO ORDERED.
s/ Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
8

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DOCUMENT 2: USCOURTS-cofc-1_18-vv-00832-1
Date issued/filed: 2020-06-08
Pages: 6
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/07/2020) regarding 39 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-00832-UNJ Document 42 Filed 06/08/20 Page 1 of 6
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-0832V
UNPUBLISHED
KIMBERLY A. PURTILL, Chief Special Master Corcoran
Petitioner, Filed: May 7, 2020
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Table Injury;
HUMAN SERVICES, Influenza (Flu) Vaccine; Shoulder
Injury Related to Vaccine
Respondent. Administration (SIRVA)
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for petitioner.
Robert Paul Coleman, III, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
On June 12, 2018, Kimberly A. Purtill filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that she suffered left shoulder injuries related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine received on September
30, 2015. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On July 31, 2019, Respondent filed his Rule 4(c) Report (ECF No. 24) and a motion
to dismiss (ECF No. 25). Respondent requested dismissal based upon the contention
that Petitioner had failed “to provide evidence to satisfy the six-month severity
requirement provided by Section 11(c)(1)(D)(i) of the Vaccine Act.” Motion to Dismiss at
1 Because this unpublished ruling contains a reasoned explanation for the action in this case, I am required
to post it on the United States Court of Federal Claims' website in accordance with the E-Government Act
of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic Government
Services). This means the ruling will be available to anyone with access to the internet. In
accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other
information, the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I
agree that the identified material fits within this definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C.
§ 300aa (2012).

Case 1:18-vv-00832-UNJ Document 42 Filed 06/08/20 Page 2 of 6
*1. Although Petitioner had alleged that her injuries lasted more than six months, she
“included no citation for this statement.” Rule 4(c) Report at *4. Respondent conceded
that Petitioner had attended appointments with medical providers outside of the six-month
timeframe, but asserted that “at none of those visits did she mention any left shoulder
complaints.” Id. at *4-5. In addition, at Petitioner’s last visit for shoulder pain just short of
six months after her injury, her doctor “indicated that petitioner’s condition was much
improved and that she did not require any additional medication.” Id. at *5. Accordingly,
Respondent argued that there was no objective contemporaneous evidence that
Petitioner had suffered from left shoulder pain for more than six months. Id. Respondent
raised no other challenges to Petitioner’s success in establishing a Table SIRVA claim.
On November 12, 2019, I issued an order denying Respondent’s motion to
dismiss, and making a factual finding that Petitioner had satisfied the six-month
requirement. Order Denying Motion to Dismiss and Finding of Fact on Six Month
Requirement, issued Nov. 12, 2019 (ECF No. 31). I found that the evidence showed that
Petitioner was seen by her doctor seven days short of the end of the six-month period,
and that at this appointment the record indicated that most of Petitioner’s pain was gone
– allowing the inference that it was not completely gone. Id. at *7. I found that more likely
than not, her injury did not fully resolve within the following week. Id. at *7-8. On this basis,
and while it was a close case, I found that Petitioner had established that she had suffered
the residual effects of her injury for more than six months. Id. at *8.
Respondent was then directed to file a status report indicating how he intended to
proceed. Id. at *8. On December 12, 2019, Respondent filed a status report stating that
he intended to continue to defend this case, but not identifying any reasons why I should
not find that Petitioner is entitled to compensation. Respondent’s Status Report, filed Dec.
12, 2019 (ECF No. 33).
On February 6, 2020, a telephonic conference was held to discuss the matter’s
status. Following the status conference, Respondent was directed to file either an
amended Rule 4(c) Report or general status report indicating how Respondent wished to
proceed. Scheduling Order, issued Feb. 6, 2020 (ECF No. 37). On February 20, 2020,
Respondent filed a status report stating that he did “not have anything to add to his
previously filed Rule 4(c) Report.” Respondent’s Status Report, filed Feb. 20, 2020 (ECF
No. 38).
In this case, Respondent’s sole objection involved whether Petitioner had provided
sufficient evidence to meet the six month requirement. While this was a close case, I ruled
in Petitioner’s favor on this issue. No other issues related to entitlement have been raised.
After a review of the entire record, I find that Petitioner is entitled to compensation.
2

Case 1:18-vv-00832-UNJ Document 42 Filed 06/08/20 Page 3 of 6
I. Factual Findings and Ruling on Entitlement
A. Legal Standards
Before compensation can be awarded under the Vaccine Act, a petitioner must
demonstrate, by a preponderance of evidence, all matters required under Section
11(c)(1), including the factual circumstances surrounding her claim. Section 13(a)(1)(A).
In making this determination, the special master or court should consider the record as a
whole. Section 13(a)(1). Petitioner’s allegations must be supported by medical records or
by medical opinion. Id.
To resolve factual issues, the special master must weigh the evidence presented,
which may include contemporaneous medical records and testimony. See Burns v. Sec'y
of Health & Human Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (explaining that a special
master must decide what weight to give evidence including oral testimony and
contemporaneous medical records). Contemporaneous medical records are presumed to
be accurate. See Cucuras v. Sec’y of Health & Human Servs., 993 F.2d 1525, 1528 (Fed.
Cir. 1993). To overcome the presumptive accuracy of medical records testimony, a
petitioner may present testimony which is “consistent, clear, cogent, and compelling.”
Sanchez v. Sec'y of Health & Human Servs., No. 11–685V, 2013 WL 1880825, at *3 (Fed.
Cl. Spec. Mstr. Apr. 10, 2013) (citing Blutstein v. Sec'y of Health & Human Servs., No.
90–2808V, 1998 WL 408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998)).
In addition to requirements concerning the vaccination received, the duration and
severity of petitioner’s injury, and the lack of other award or settlement,3 a petitioner must
establish that she suffered an injury meeting the Table criteria, in which case causation
is presumed, or an injury shown to be caused-in-fact by the vaccination she received.
§ 11(c)(1)(C).
The most recent version of the Table, which can be found at 42 C.F.R. § 100.3,
identifies the vaccines covered under the Program, the corresponding injuries, and the
time period in which the particular injuries must occur after vaccination. Section 14(a).
Pursuant to the Vaccine Injury Table, a SIRVA is compensable if it manifests within 48
hours of the administration of an influenza vaccine. 42 C.F.R. § 100.3(a)(XIV)(B). The
criteria establishing a SIRVA under the accompanying QAI are as follows:
Shoulder injury related to vaccine administration (SIRVA). SIRVA manifests
as shoulder pain and limited range of motion occurring after the
administration of a vaccine intended for intramuscular administration in the
upper arm. These symptoms are thought to occur as a result of unintended
injection of vaccine antigen or trauma from the needle into and around the
underlying bursa of the shoulder resulting in an inflammatory reaction.
3 In summary, a petitioner must establish that she received a vaccine covered by the Program, administered
either in the United States and its territories or in another geographical area but qualifying for a limited
exception; suffered the residual effects of her injury for more than six months, died from her injury, or
underwent a surgical intervention during an inpatient hospitalization; and has not filed a civil suit or collected
an award or settlement for her injury. See § 11(c)(1)(A)(B)(D)(E).
3

Case 1:18-vv-00832-UNJ Document 42 Filed 06/08/20 Page 4 of 6
SIRVA is caused by an injury to the musculoskeletal structures of the
shoulder (e.g. tendons, ligaments, bursae, etc.). SIRVA is not a neurological
injury and abnormalities on neurological examination or nerve conduction
studies (NCS) and/or electromyographic (EMG) studies would not support
SIRVA as a diagnosis (even if the condition causing the neurological
abnormality is not known). A vaccine recipient shall be considered to have
suffered SIRVA if such recipient manifests all of the following:
(i) No history of pain, inflammation or dysfunction of the affected shoulder
prior to intramuscular vaccine administration that would explain the alleged
signs, symptoms, examination findings, and/or diagnostic studies occurring
after vaccine injection;
(ii) Pain occurs within the specified time frame;
(iii) Pain and reduced range of motion are limited to the shoulder in which
the intramuscular vaccine was administered; and
(iv) No other condition or abnormality is present that would explain the
patient’s symptoms (e.g. NCS/EMG or clinical evidence of radiculopathy,
brachial neuritis, mononeuropathies, or any other neuropathy).
42 C.F.R. § 100.3(c)(10).
B. Factual Findings Regarding QAI Criteria for Table SIRVA
After a review of the entire record, I find that a preponderance of the evidence
demonstrates that Petitioner has satisfied the QAI requirements for a Table SIRVA.
1. Prior Condition
The first QAI requirement for a Table SIRVA is lack of a history revealing problems
associated with the affected shoulder which were experienced prior to vaccination and
would explain the symptoms experienced after vaccination. 42 C.F.R. § 100.3(c)(10)(i).
Respondent has not contested that Petitioner meets this criterion, and I find that
she has demonstrated a lack of history of pain, inflammation, or dysfunction of her left
shoulder that would explain her symptoms. See Ex. 7 at ¶ 4; Ex. 4.
2. Onset of Pain
Pursuant to Section 13(b)(2) of the Vaccine Act, a special master may find that the
first symptom or manifestation of onset occurred within the time period set forth in the
Table even if the occurrence of such symptom or manifestation was not recorded or was
incorrectly recorded as having occurred outside such period.
In my November 12, 2019 Order, I determined that the onset of petitioner’s left
shoulder injuries occurred immediately after her September 30, 2015 influenza
vaccination based on medical records and petitioner’s testimony and affidavit. Order on
4

Case 1:18-vv-00832-UNJ Document 42 Filed 06/08/20 Page 5 of 6
Motion to Dismiss and Finding of Fact, issued Nov. 12, 2019, at *7 (ECF No. 31); see
also Ex. 2 at 1-2 (listing date of injury as 9/30/15 and stating the reason for visit as “got a
flu shot on Sept 30th, still left shoulder [joint] is hurting a lot”); Ex. 3 at 1(noting that
Petitioner complained of “continued left shoulder aching pain for the past 3 weeks. Patient
states she [received] her flu shot in her left deltoid 3 weeks ago . . . that evening she
started noticing mild aching pain in the left shoulder and states pain has progressed
since.”). Thus, petitioner has demonstrated by a preponderance of the evidence that her
injury occurred within 48 hours, the time specified in the Table for a SIRVA.
3. Scope of Pain and Limited ROM
Respondent has not contested that Petitioner meets this criterion. In addition, the
medical records document symptoms only in Petitioner’s left shoulder following her
vaccine. 4 Ex. 2 at 1, 2. I thus find that Petitioner has demonstrated by a preponderance
of the evidence that her pain and reduced range of motion were limited to the shoulder in
which the intramuscular vaccine was administered.
4. Other Condition or Abnormality
The last QAI criteria for a Table SIRVA states that there must be no other condition
or abnormality which would explain a petitioner’s current symptoms. 42 C.F.R.
§ 100.3(c)(10)(iv). There is no evidence that Petitioner suffered any other condition which
would explain her symptoms of pain and limited ROM in her left shoulder. Nor has
Respondent identified any such other condition or abnormality.
I find the record contains preponderant evidence establishing that there is no other
condition or abnormality which would explain the symptoms of Petitioner’s left shoulder
injury.
C. Other Requirements for Entitlement
In addition to establishing a Table injury, a petitioner must also provide
preponderant evidence of the additional requirements of Section 11(c). Respondent does
not dispute that Petitioner has satisfied these requirements in this case, and the overall
record contains preponderant evidence to fulfill these additional requirements.
The record shows that Petitioner received the flu vaccine intramuscularly in her left
arm on September 30, 2015 at a health clinic located in Charlotte, North Carolina. Ex. 1
at 1; Ex. 5 at ¶ 2; see Section 11(c)(1)(A) (requiring receipt of a covered vaccine); Section
11(c)(1)(B)(i)(I) (requiring administration within the United States or its territories). There
is no evidence that Petitioner has collected a civil award for her injury. Ex. 5 at ¶ 6; Section
11(c)(1)(E) (lack of prior civil award).
4 I am aware that Petitioner suffered from bilateral scapular pain over a year after vaccination. Ex. 4 at 80.
On examination, she was found to have bilateral “trapezius spasm with palpable tenderness.” Id. at 82. This
does not outweigh the remaining extensive evidence of symptoms only in Petitioner’s left shoulder following
vaccination.
5

Case 1:18-vv-00832-UNJ Document 42 Filed 06/08/20 Page 6 of 6
As stated in the previous section, I have found that the onset of Petitioner’s left
shoulder pain was immediate and thus, within 48 hours of vaccination. See 42 C.F.R.
§ 100.3(c)(10)(ii) (setting forth this QAI requirement). This finding also satisfies the
requirement that Petitioner’s first symptom or manifestation of onset occur within the time
frame listed on the Vaccine Injury Table. 42 C.F.R. § 100.3(a)(XIV)(B) (listing a time frame
of 48 hours for a Table SIRVA following receipt of the influenza vaccine). Therefore,
Petitioner has satisfied all requirements for a Table SIRVA.
The last criteria which must be satisfied by Petitioner involves the duration of her
SIRVA. For compensation to be awarded, the Vaccine Act requires that a petitioner suffer
the residual effects of his or her left shoulder injury for more than six months. See Section
11(c)(1)(D)(i) (statutory six-month requirement). But in my November 12, 2019 Order and
Fact Ruling, I found that Petitioner had established that she suffered the residual effects
of her injury for more than six months. Thus, this requirement is also met.
Based upon all of the above, Petitioner has established that she suffered a Table
SIRVA. Additionally, she has satisfied all other requirements for compensation. I therefore
find that Petitioner is entitled to compensation in this case.
In view of Respondent’s position and the evidence of record, I find that
Petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
6

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DOCUMENT 3: USCOURTS-cofc-1_18-vv-00832-2
Date issued/filed: 2021-02-01
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 12/04/2020) regarding 49 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
--------------------------------------------------------------------------------
Case 1:18-vv-00832-UNJ Document 53 Filed 02/01/21 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-0832V
UNPUBLISHED
KIMBERLY A. PURTILL, Chief Special Master Corcoran
Petitioner, Filed: December 4, 2020
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Influenza (Flu) Vaccine; Shoulder
Injury Related to Vaccine
Respondent. Administration (SIRVA)
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for petitioner.
Mallori Browne Openchowski, U.S. Department of Justice, Washington, DC, for
respondent.
DECISION AWARDING DAMAGES1
On June 12, 2018, Kimberly A. Purtill filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that she suffered left shoulder injuries related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine received on September
30, 2015. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On May 7, 2020, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On December 4, 2020, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $50,000.00. Proffer at
1. In the Proffer, Respondent represented that Petitioner agrees with the proffered award.
1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am
required to post it on the United States Court of Federal Claims' website in accordance with the E-
Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic
Government Services). This means the decision will be available to anyone with access to the
internet. In accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact
medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy.
If, upon review, I agree that the identified material fits within this definition, I will redact such material from
public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C.
§ 300aa (2012).

Case 1:18-vv-00832-UNJ Document 53 Filed 02/01/21 Page 2 of 4
Id. Based on the record as a whole, I find that Petitioner is entitled to an award as stated
in the Proffer.
Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump
sum payment of $50,000.00 in the form of a check payable to Petitioner. This amount
represents compensation for all damages that would be available under § 15(a).
The clerk of the court is directed to enter judgment in accordance with this
decision.3
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by the parties’ joint filing of notice
renouncing the right to seek review.
2

Case 1:18-vv-00832-UNJ Document 53 Filed 02/01/21 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
KIMBERLY A. PURTILL,
Petitioner, No. 18-832V
Chief Special Master Corcoran
v. SPU
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
On November 12, 2019, Chief Special Master Corcoran issued a Fact Ruling, finding that
petitioner satisfied the six-month severity requirement set forth in Section 11(c)(1)(D)(i) of the
Vaccine Act. Thereafter, on May 7, 2020, Chief Special Master Corcoran issued a Ruling on
Entitlement finding that petitioner was entitled to vaccine compensation for her Shoulder Injury
Related to Vaccine Administration (“SIRVA”). Based on the evidence of record, respondent
proffers that petitioner should be awarded $50,000.00.1 This amount represents all elements of
compensation to which petitioner would be entitled under 42 U.S.C. § 300aa-15(a).2 Petitioner
agrees.
1 The parties have no objection to the amount of the proffered award of damages. However,
respondent reserves his right, pursuant to 42 U.S.C. § 300aa-12(e), to seek review of the Chief
Special Master’s May 7, 2020 entitlement decision.
2 Should petitioner die prior to entry of judgment, the parties reserve the right to move the Court
for appropriate relief. In particular, respondent would oppose any award for future lost earnings
and future pain and suffering.

Case 1:18-vv-00832-UNJ Document 53 Filed 02/01/21 Page 4 of 4
II. Form of the Award
The parties recommend that compensation provided to petitioner should be made through
a lump sum payment of $50,000.00, in the form of a check payable to petitioner. Petitioner
agrees. Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
JEFFREY BOSSERT CLARK
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
CATHARINE E. REEVES
Deputy Director
Torts Branch, Civil Division
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
s/ Mallori B. Openchowski
MALLORI B. OPENCHOWSKI
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Ben Franklin Station
Washington, DC 20044-0146
Tel.: (202) 305-0660
DATED: December 4, 2020
2